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Gluten Ataxia in Japan

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Abstract

Gluten ataxia, a type of cerebellar ataxia caused by exposure to gluten in sensitive patients, has been considered common in the USA and Europe, and rare in Asia. We measured anti-deamidated gliadin peptide (DGP) antibody levels in 49 patients with cerebellar ataxia, excluding those with multiple system atrophy, hereditary spinocerebellar ataxia, or cancer, as well as those who were receiving oral administration of phenytoin. Anti-DGP antibody was positive in eight (16.3 %) patients, five of these patients were positive only for IgA, one was positive for both IgG and IgA, and two were positive only for IgG antibody. Intravenous immunoglobulin was administered to five of the eight patients, and was markedly effective in one, moderately effective in two, and ineffective in two. Steroid therapy was administered to four patients, but none had an apparent response. Ataxia symptoms improved in one patient treated with a gluten-free diet only. Although it had been thought to be extremely rare in Asia, we speculate that more than 10 % of cerebellar ataxia patients in Japan currently have gluten ataxia; therefore, measuring anti-DGP antibody or anti-gliadin antibody in cerebellar ataxia patients in Asia is important.

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Acknowledgments

The authors express their gratitude to Mr. C. W. P. Reynolds, associated with the Department of International Medical Communications of Tokyo Medical University, for his careful revision of the English of this paper.

Funding

None of the authors have any external sources of funding to report.

Competing Interests

None of the authors have any conflicts of interest to report.

Patient Consent

Informed consent was obtained from all patients included in this report.

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Authors and Affiliations

  1. Department of Neurology, Hachioji Medical Center, Tokyo Medical University, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan

    Kazunori Nanri, Nobuyuki Tanaka, Takeshi Taguchi, Masafumi Takeguchi & Tomoko Ishiko

  2. Post-graduate Clinical Residents’ Center, Tokyo Medical University, Shinjuku, Tokyo, 160-0023, Japan

    Hiroshi Mitoma

  3. Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, 565-8565, Japan

    Masafumi Ihara

  4. National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8551, Japan

    Hidehiro Mizusawa

Authors
  1. Kazunori Nanri
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  2. Hiroshi Mitoma
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  3. Masafumi Ihara
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  4. Nobuyuki Tanaka
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  5. Takeshi Taguchi
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  6. Masafumi Takeguchi
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  7. Tomoko Ishiko
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  8. Hidehiro Mizusawa
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Correspondence to Kazunori Nanri.

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Nanri, K., Mitoma, H., Ihara, M. et al. Gluten Ataxia in Japan. Cerebellum 13, 623–627 (2014). https://doi.org/10.1007/s12311-014-0582-3

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  • DOI: https://doi.org/10.1007/s12311-014-0582-3

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